Cervical fusion is a surgical procedure that joins two or more vertebrae in the neck to create a solid, immobile segment of bone. The surgery alleviates pain from conditions like herniated discs or stabilizes the spine after an injury by eliminating motion at the affected segment. However, this rigidity introduces a new vulnerability, and a car accident involving sudden movements of the head and neck poses a unique danger to individuals with a cervical fusion.
Immediate Medical Concerns and Actions
Following any car accident, immediate medical evaluation is required for an individual with a prior cervical fusion. Call for emergency medical assistance and inform first responders about the pre-existing fusion. This information helps them take appropriate precautions when stabilizing the neck and preparing for transport.
At the emergency room, inform the medical staff about the specifics of your cervical fusion, including the surgery date and which vertebral levels were fused, for instance, C5-C6. This information allows the examining physician to accurately assess the situation.
Clearly describe any new symptoms, distinguishing them from chronic issues that existed before the accident. Detail any new pain, numbness, tingling, or weakness in the neck, shoulders, arms, or hands. Also report a loss of coordination, balance, or dexterity, as this can indicate a new neurological injury.
Potential Injuries to a Fused Spine
A cervical fusion creates a rigid block of bone where flexible joints once existed. During the whiplash motion of a car accident, this stiff segment acts as a lever, transferring impact forces to the mobile vertebrae directly above and below it. This concentration of stress places immense pressure on the adjacent spinal structures, making them susceptible to specific injuries.
The most common complication is Adjacent Segment Disease (ASD), where the discs and joints next to the fusion experience increased wear. A car accident can accelerate this process, causing an adjacent disc to herniate or a joint to fracture. This may lead to new spinal instability or nerve compression, resulting in pain, numbness, or weakness.
Another concern involves the surgical hardware, such as plates and screws, used to create the fusion. The force from a collision can cause this hardware to loosen, bend, or break. If screws pull away from the bone or a plate fractures, the stability of the fused segment is compromised, causing pain and posing a risk to the spinal cord.
The vertebrae themselves are also at risk. A strong impact can fracture the vertebrae adjacent to the fusion or the solid bone mass of the fusion itself. This is a particular risk if the fusion is not yet mature. An accident before the bone graft has solidified can disrupt healing and result in a non-union, where the bones fail to fuse.
Diagnosis and Treatment Pathways
To determine the extent of new injuries after a car accident, physicians use imaging studies to visualize the neck’s structures. An X-ray is often the first step, as it can reveal spinal alignment, the position and integrity of surgical hardware, and any obvious vertebral fractures.
For a more detailed assessment, a computed tomography (CT) scan may be ordered to get a clearer view of the bones than X-rays provide. CT scans are effective for identifying subtle fractures and evaluating the placement of hardware. An MRI may also be used to examine soft tissues like discs and ligaments.
The treatment approach depends on the injury’s nature and severity. For less severe issues like minor disc bulging or sprains, non-surgical management is recommended. This includes immobilizing the neck with a brace, physical therapy to strengthen supporting muscles, and medication to manage pain and inflammation.
Surgery becomes necessary for spinal instability, nerve compression, or hardware failure. A revision surgery may be required to remove or replace compromised hardware like a loosened screw or broken plate. In cases of severe adjacent segment disease, the surgeon may need to extend the original fusion to include the newly damaged level.
Legal and Compensation Considerations
The legal aftermath of a car accident is complicated by a pre-existing cervical fusion. A concept in these cases is the “Eggshell Skull” doctrine, which holds that an at-fault driver is responsible for all resulting harm, even if the person was more susceptible to injury. In simple terms, the defendant must take the victim as they find them.
A challenge in these cases is proving causation, meaning the legal team must demonstrate that new injuries were directly caused by the accident. This requires thorough documentation, including medical records from before and after the crash. Expert medical testimony is often necessary to explain how the trauma led to new damage like ASD or hardware failure.
Cases involving the aggravation of a cervical fusion have a higher potential for compensation because the injuries are more severe. This leads to more extensive medical care, including costly revision surgeries. The long-term impact on quality of life, such as chronic pain and physical limitations, also increases the value of damages. The need for future medical care is another factor in determining a final settlement.